Practice Pulse QUESTION: Should an exam be performed with every rabies vaccination? Is an exam within the last year considered acceptable? If a client declines an annual exam, can a rabies vaccination still be given? A: The standard of practice for a limited service (vaccination) clinic requires a physical exam be performed on every animal to be vaccinated. There seems to be no reason why the standard for a regular clinic would be less. 61G18-15.007 Minimum Standards for Limited-Service Veterinary Medical Practices. (1) The term “limited-service veterinary medical practice” shall mean a privately or publicly supported vaccination clinic where a veterinarian performs for a limited time vaccinations and/or immunizations against disease on multiple animals, and where the veterinarian may also perform microchipping and preventative procedures for parasitic control, and shall not mean a premise otherwise permitted by the Board. (2) The Limited-Service permittee shall register each clinic with the Board of Veterinary Medicine by name, address, date of clinic, time and duration, at least 28 days prior to offering a limited-service clinic. A copy of the limitedservice permit shall be clearly visible at each limited service clinic held during its hours of operation and posted at the main office where the records are stored. (3) A veterinarian must remain on site throughout the duration of a limited-service clinic and must maintain autonomy for all medical decisions made. A physical examination and history must be taken for each patient receiving veterinary medical care at a limited-service clinic. Recommendations and preventive medicine protocols must be developed from current accepted veterinary medical practice. The veterinarian is responsible for proper immunization and parasitic procedures and the completeness of recommendations made to the public by the paraprofessional staff that the veterinarian supervises or employs. The veterinarian is responsible for consultation and referral of clients when disease is detected or suspected. The annual exam is a fairly common standard of practice. If the animal was examined by the veterinarian/practice less than 1 year ago, another exam may not be necessary. If a client declines an annual exam, the veterinarian should explain that the standard of practice requires that examination be performed before providing the vaccination. If the veterinarian gives the rabies vaccination without having performed some type of physical examination and there is an adverse reaction that could have been avoided with a physical
30 | FVMA ADVOCATE
examination, the veterinarian will not be able to defend him/ herself.
QUESTION: What type of signature is needed on rabies vaccination certificates? I recently had a situation where a receptionist changed a patient's weight in the medical record and provided the certificate to a client without my knowledge. Should I be signing each rabies certificate personally? What is the recommended policy on protecting signature stamps if those are used? A: A rabies vaccination certificate can be signed using a rubber stamp: (3) Upon vaccination against rabies, the licensed veterinarian shall provide the animal’s owner and the animal control authority with a rabies vaccination certificate. Each animal control authority and veterinarian shall use the “Rabies Vaccination Certificate” of the National Association of State Public Health Veterinarians (NASPHV) or an equivalent form approved by the local government that contains all the information required by the NASPHV Rabies Vaccination Certificate. The veterinarian who administers the rabies vaccine to an animal as required under this section may affix his or her signature stamp in lieu of an actual signature. A signature stamp should be protected to the same extent as blank certificates or your prescription pad. If you leave these out in the open and people forge certificates or prescriptions, you may be deemed to have acted negligently.
QUESTION: We recently had a client come in and ask us if we could give her a copy of her pet's rabies certificate. Our receptionist fulfilled this request for her. The next day the same client's daughter came in and said that she lost the copy and asked for another. She then told the receptionist that the weight we had on the certificate was incorrect and asked that we change it. The receptionist changed it and reprinted the certificate with the lower weight, based on what the client was telling her. The receptionist then told the client's daughter that she could not permanently change it, until she brings the pet in for a weight check and reverted the weight back. This client gave her new apartment complex an old rabies certificate in addition to the new one with the lowered (unverified) weight listed on it. The apartment complex is now calling and asking what is going on and which weight/certificate is correct. A: Our legal counsel advises the following: 1. A receptionist or other clinic staff can perform the clerical act of reprinting or copying a patient record or certificate, but
